Living 24 hours a day connected to a machine to breathe: "Please don't smoke"

BarcelonaGemma has been living permanently connected to a machine for two years now, without which she couldn't breathe. She is 69 years old and has always been very athletic, passionate about hiking, and has always traveled with her husband in a camper van. Now she can no longer go mushroom picking or swimming in the sea, and she must monitor her altitude when she is in the mountains because of the respiratory failure she suffers from, called chronic obstructive pulmonary disease (COPD)which is closely linked to smoking. She had been smoke-free for ten years when she was diagnosed with this chronic illness, but before quitting, she smoked a pack a day for over 30 years. "I went to the doctor for pneumonia when I was 50, and he told me, 'Either you quit, or you won't make it to Christmas,'" she recalls from her dining room.

In total, Gemma needs up to four machines daily. One she uses in the mornings, another at night, one of the larger ones, and a smaller, portable one with a six-hour battery life for when she leaves the house. However, the condition is relentless and increasingly limits her. "Look at me, and you'll know where this is headed."

Like Gemma, there are approximately three million people in Spain who suffer from this disease, according to data from the Spanish Society of General Practitioners and Family Physicians, which warns that there is significant underdiagnosis. COPD is the cause of 75% of cases worldwide. While curable, it is preventable and treatable if action is taken in time, explains Adriana Pascuas, respiratory physiotherapist and head of care at Esteve Teijin in Catalonia, a company that provides treatment to 6,000 Catalans with COPD. The expert maintains that early diagnosis and adherence to treatment are the main challenges currently. Symptoms include morning mucus and a feeling of suffocation, especially among smokers, as smoking is the leading cause of the disease.

Between sixteen and eighteen hours of oxygen daily are required.

Pascuas also argues that smokers over 40 who experience these symptoms should be screened, because many of them normalize them and don't consult a doctor until they are in advanced stages of the disease, when the prognosis is much worse. If a patient who needs oxygen doesn't use it, their organs don't receive what they need, and their functional capacity deteriorates rapidly. Gemma remembers one morning when the cable disconnected without her noticing; she was dizzy and weak, unable to walk. "For the therapy to be effective, it's necessary to use oxygen for at least sixteen to eighteen hours a day," explains the expert. With this treatment, patients find it easier to breathe, the low blood oxygen level is corrected, and their survival and quality of life increase, she adds. This dependence, however, has risks. Gemma still remembers the anxiety it caused her.massive power outage of April 28She was worried about losing the oxygen supply from the machines that provide her with the necessary oxygen. She always makes sure her portable oxygen concentrator is ready for any emergency, and that day it lasted until the power came back on. "I set it to the lowest setting and moved as little as possible. I sat on the sofa and read until the power returned, but otherwise, I would have had to rush to the hospital," the patient explains. "When the power goes out, you're on high alert because you never know when it will come back on or if the battery will last. I need oxygen 24/7." Gemma is grateful that neither of her two children has ever smoked, probably because their parents smoked heavily when they were young. Pascuas maintains that there is no "safe threshold" for smoking and that smoking lightly does not eliminate the risk of COPD. It also maintains that quitting smoking years earlier does not prevent the onset of symptoms if lung damage was already done, as in Gemma's case, and that people exposed to secondhand smoke—because they live with smokers—have a higher risk of developing the disease. Meanwhile, the number of smokers in Catalonia has remained stable for almost a decade, and the fight against tobacco continues to stall, awaiting new restrictions such as banning smoking on bar and restaurant terraces.